Despite rapid growth in China, it is unclear whether the poor have benefited in terms of nutrition. This paper’s goal is to understand the prevalence of anemia among school children in western China.We report on results from seven cross-sectional surveys involving 12,768 age 8-12 students. Sample students were selected randomly from 283 primary schools in 41 poor counties of Ningxia, Qinghai, Shaanxi and Sichuan provinces. Data were collected through questionnaires and hemoglobin tests. The dataset represents 7 million age 8-12 children in poor western counties. The anemia prevalence was 34% using the WHO’s hemoglobin cutoff of < 120g/L. Students who boarded at school and girls were more likely to be anemic. Assuming the sample population is representative of poorregions in western China, nearly2.5 million 8-12 year old school children in the region may be anemic and many more iron deficient. Given China’s growth, such high prevalence of anemia is surprising and illustrative of the large health disparities in the country. Iron deficiency remains a significant nutrition issue, though there appears to be no effort to address this issue.